Emergence of Klebsiella pneumoniae coproducing KPC-2 and 16S rRNA methylase ArmA in Poland

A Klebsiella pneumoniae epidemic strain that coproduced carbapenemase KPC-2 (K. pneumoniae carbapenemase 2) and 16S rRNA methylase ArmA has emerged in Poland. Four nonduplicate isolates from patients in a hospital in Warsaw, Poland, were found to carry the bla(KPC-2) and armA genes on ca. 50-kb and 90-kb plasmids, respectively. Tn4401 with a 100-bp deletion in the variable region was detected in all the isolates. XbaI pulsed-field gel electrophoresis (PFGE) revealed 93.2% similarity of the isolates. All the isolates were resistant to carbapenems and 4,6-disubstituted 2-deoxystreptamines.     

Studies on the regeneration of rat intestinal epithelium after exposure to cyclophosphamide

Cyclophosphamide caused changes in Paneth cells. The relationship of these changes to the proliferative reaction of the intestinal epithelium requires a more complete knowledge of various physiological functions of Paneth cells.     

Countrywide Spread of CTX-M-3 Extended-Spectrum β-Lactamase-Producing Microorganisms of the Family Enterobacteriaceae in Poland

Eighty-four clinical isolates of the family Enterobacteriaceae, recovered from 1998 to 2000 in 15 hospitals in 10 Polish cities, were analyzed. All the isolates produced beta-lactamases with pIs of 8.4 and 5.4, and the pI 8.4 enzymes were demonstrated to hydrolyze cefotaxime but not ceftazidime in the in vitro bioassay. PCR analysis and DNA sequencing have revealed that in all cases the pI 8.4 beta-lactamase was probably the CTX-M-3 extended-spectrum beta-lactamase (ESBL) variant, which was originally identified in 1996 in Praski Hospital in Warsaw. In the majority of isolates, bla(CTX-M-3) genes resided within large conjugative plasmids with similar fingerprints, which, in the context of the high degree of diversity of the randomly amplified polymorphic DNA types of the isolates, suggested that horizontal transfer of plasmids was likely the main mechanism of CTX-M-3 spread. The dissemination of plasmids was probably preceded by the center-to-center transmission of several strains, as indicated by the identification by pulsed-field gel electrophoresis of closely related or possibly related Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii isolates in five different hospitals. CTX-M-3-producing organisms revealed a very high degree of diversity in beta-lactam resistance levels and patterns. This was attributed to several factors, such as the production of other beta-lactamases including additional ESBLs, possible quantitative variations in CTX-M-3 expression, segregation of AmpC derepressed mutants, and permeability alterations.     

The effect of dietary enrichment with fish-oil on urinary excretion of N-acetyl-beta-D-glucosaminidase and renal function in proteinuric patients with primary glomerulopathies

The rate of progression of renal disease depends on many factors including serum lipids and tubulo-interstitial injury. Aim of the study was to see whether fish-oil therapy may affect serum lipids and NAG excretion with urine (a marker of tubular cell damage) in humans with renal disease. The effects of dietary fish-oil fatty acids on the serum lipids, NAG urinary excretion and serum arachidonic acid concentration were examined in thirteen primary glomerulonephritic patients with proteinuria and normal renal function. The regular diet enriched with 1650 mg n−3 polyunsaturated fatty acids (18%: 20∶5; n−3 EPA and 12%: 22∶5; n−3 DHA) was ingested for three months. At the end of fish-oil enriched diet neither creatinine clearance nor urinary protein excretion changed significantly. But serum concentration of HDL and arachidonic acid increased (48.0±15 vs. 52.0±14; p<0.05), (0.47±0.13 vs. 0.72±0.29; p<0.01), respectively. Simultaneously urine NAG excretion and serum LDL decreased (11.2±7.1 vs. 10.3±7.3; p<0.05), (163.0±57 vs. 149.0±51, p<0.01), respectively. We presume that fish-oil supplementation may have a beneficial effect on renal tubular cells in humans and it could be linked with arachidonic acid metabolism.     

Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis isolated from the nasopharynges of asymptomatic children and molecular analysis of S. pneumoniae and H. influenzae strain replacement in the nasopharynx

Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in 226 children in different settings (in a crèche [day care center], in an orphanage, and at home) during two seasons (winter and spring) was studied. The rates of carriage of S. pneumoniae and H. influenzae were markedly higher in the crèche and in the orphanage than in the home setting (e.g., 56.5, 63.3, and 25.9%, respectively, for S. pneumoniae in winter). Approximately 80% of the S. pneumoniae isolates identified in the crèche and in the orphanage belonged to the serotypes represented in the seven-valent pneumococcal vaccine, and 4.4% of the children were colonized by H. influenzae type b. Almost all H. influenzae isolates were fully susceptible to the antimicrobial agents tested, and only five (3.6%) produced beta-lactamase; in contrast, 100% of the M. catarrhalis isolates were beta-lactamase positive. Among S. pneumoniae isolates, 36.2% were nonsusceptible to penicillin (PNSP) and 11.8% were fully resistant to penicillin (PRP). All PNSP isolates were obtained from children at the crèche and at the orphanage but not among children brought up at home, and all PRP isolates showed a multiresistant phenotype. Colonization by PRP isolates correlated well with prior treatment with beta-lactams. For the majority of children colonized at both sampling times, strain replacement of S. pneumoniae and H. influenzae was observed; long-term colonization by a single strain was rare.